An
Information Service of the Cuba Transition ProjectInstitute for Cuban and Cuban-American Studies
University of Miami

Issue 137

January 20, 2011

Vanessa Lopez*

The
Cuban Government and Multi-Million Dollar Medicare Fraud in South
Florida

The dilapidated state of
the Cuban economy has left the Cuban government scrambling for ways
to obtain hard currency. Cuba has contrived ways to benefit from leasing
doctors, nurses, teachers, and security agents abroad; more recently,
Cuba has also found ways to capitalize on large-scale Medicare fraud,
possibly committing economic warfare on the United States.

Medicare fraud is one
of the highest dollar volume crimes in the United States. In October
of 2009, it was estimated that such fraud has reached $60 billion a
year. (1) And South Florida has become the epicenter
of this federal crime.

Federal authorities, in
July of 2010 in conjunction with the first Healthcare Fraud Summit (taking
place, rather symbolically, in Miami), led a crackdown in the 5 major
U.S. cities that have the dubious recognition of being the largest Medicare
fraud perpetrators: Miami, Brooklyn, Baton Rouge, Detroit, and Houston.
Of the 94 people charged by authorities for fraud, 25 are from Miami-Dade.
(2) Florida’s mental health claims are 4 times
higher than Texas, where healthcare fraud is also substantial (Florida’s
population is ¾ that of Texas’). Florida’s physical
and speech therapy claims are 140 times higher than New York’s
(while New York’s population has 1 million more people than Florida’s)
and 10 times higher than in California (which has a population double
the size of Florida’s). Ultimately, South Florida is responsible
for one-third of the nation’s healthcare fraud prosecutions. (3)

The question should be
posed: What makes South Florida different from any other region and
can account for the troubling number of fraudulent claims emanating
from the area?

Given that “at least
half of South Florida’s Medicare fugitives are believed to be
[hiding] in Cuba,” it is probable that the region’s Cuban-connections
can be playing a significant role in the region’s disproportionately
high propensity to commit Medicare fraud. (4) There
are various possible reasons for this:

New Cubans arriving to South Florida have become accustomed to
lawlessness – a condition of living under a totalitarian regime
whereby one needs to regularly resort to illegal acts as a means of
survival. This adaptation purportedly predisposes them to embrace
opportunities for Medicare fraud. Many troubling questions can be
raised against this hypothesis: Why is this phenomenon mostly associated
with Medicare and not other crimes? Why is it that the criminals behind
this fraud are not only recently arrived Cubans, but also those who
have been in South Florida for decades? Since this is the case, blaming
this crime on recently-arrived Cubans may be factually inaccurate
and discriminatory.

South Florida’s closeness to Cuba, both geographic and cultural,
provides for an easy escape to Cuba – a state with no extradition
treaty with the United States.

The Cuban Government is orchestrating and assisting
some of these instances of Medicare fraud. (5)

In a discussion with a high-level former
intelligence official with the Cuban Government, it became clear that
the latter two reasons can help account for South Florida’s high
volume of Medicare fraud cases. (6) In said discussion,
the official, who asked to remain unnamed, states that there are indeed
strong indications that the Cuban Government is directing some of these
Medicare frauds as part of a desperate attempt to obtain hard currency.
The source notes that the Cuban Government is also assisting (while
not directing) other instances of Medicare fraud – providing perpetrators
with information with which to commit fraud.

The former Cuban official goes on to
say that, in the instances where the Cuban Government is not directing
or facilitating the fraud, it does provide Cuba as a place for fugitives
to flee. This gives the Castro regime a convenient and care-free way
to raise hard currency. The source specified that any fugitive in Cuba
needs to pay astronomically large sums of money to the Cuban Government
in order to enter and remain in the country. The source pointed out
the well-known case of Robert Vesco, in which the government’s
extortion of fugitives ended up rather badly for this particular fugitive.
The official explains that Vesco paid high prices to the Cuban Government
to remain in the country, and it was only after his money ran out that
the Cuban Government sentenced him to 13 years incarceration. Vesco
died of cancer before the end of his sentence.

More recent cases of fugitives that
have fled to Cuba include: Jorge Ramirez who was charged with defrauding
Medicare of $42.2 million. Ramirez attempted to reenter the United States
in December of 2008 and was arrested. What was his motivation to return?
Had he run out of money to pay-off Cuban authorities, or did he just
think the United States had forgotten all about him? While he was personally
charged with the aforementioned sum, the ring he was working with scammed
$420 million from Medicare. His two co-defendants remain in Cuba.

There was also the case of the Benitez
brothers, who billed Medicare over $110 million in false claims between
2001 and 2004. They first fled to the Dominican Republic, but after
they thought authorities were getting too close to capturing them, they
relocated to Cuba. They are joined by Eduardo Moreno, who submitted
over $7 million in false Medicare claims. He too can be found in Havana,
along with dozens of other fugitives.

The cases of those who were unable to
flee to Cuba can also be telling – most notably, the case of former
Lieutenant Colonel Renier Vicente Rodriguez Fleitas, who served in Cuba’s
Armed Forces. (7) Rodriguez Fleitas served in Angola
and the Congo under the Cuban flag, and yet he found himself living
in Florida, perpetrating Medicare fraud. Between December 2009 and March
2010, his company, Pirifer Pharmacy and Discount, billed Medicare
$1.8 million in false claims. Rodriguez Fleitas’ defense team
claims that he was but a pawn of others. However, his connections with
Cuba have raised some red flags and the FBI continues to investigate
the case.

The Lieutenant Colonel has lived in
South Florida for the past 15 years. Although he claims that he had
been living on the streets at the time he was approached to commit the
Medicare fraud, he had traveled to Cuba every year since the time that
he had left the Island. Furthermore, Rodriguez Fleitas, at the very
time that his company was committing Medicare fraud, was actually living
in Cuba, during an 8-month “visit.” Various irregularities
in his case remain. Despite the irregularities, Rodriguez Fleitas was
sentenced to three years’ incarceration and it does not currently
seem as that he will be prosecuted for any other crimes besides Medicare
fraud.

It seems clear that the Cuban Government is partially responsible
for the disproportionately high number of cases of Medicare fraud in
the region. Its assistance to this serious and costly crime cannot be
overlooked, and its constant aiding and abetting of U.S. criminals,
simply for its economic benefit, is offensive to U.S. law-abiding citizens
who must ultimately pay for the billions of dollars worth of fraud that
stems from the assistance provided by the Castro Government.